Germany is facing a heat wave with temperatures of up to 40 degrees Celsius and more. On this occasion, the German Heart Foundation points out important precautions for people with chronic heart disease.
“Such extremely high temperatures can be a challenge, especially for older people and those who are already being treated for cardiovascular diseases such as heart failure or blood pressure problems.”
Prof. Dr. Thomas Voigtländer, cardiologist and intensive care physician, chairman of the board of the German Heart Foundation
If the heart is diseased, this usually significantly limits the performance of the body's own cooling system, which releases excessive heat from the blood via the small skin vessels. Heat can only be transported out of the body by the circulatory system with considerable effort. The result can be fatigue and dizziness as well as a drop in blood pressure and even circulatory collapse, as well as cardiac arrhythmias or muscle cramps.
“Those affected can prevent such complications by discussing special precautionary measures for extreme summer heat with their treating family doctor or cardiologist in good time, which can vary depending on the heart disease.”
Medical director of the Agaplesion Bethanien Hospital Frankfurt am Main
Important precautionary measures include adjusting the amount you drink and paying attention to your electrolyte balance. Dosage changes may also be necessary, especially if you are taking blood pressure or water-inducing medications (diuretics). The Heart Foundation provides detailed information about important recommendations for heart patients on how to deal with the summer heat at www.herzstiftung.de .
Measure blood pressure! Extreme heat causes blood pressure to drop or increase
In general, patients with cardiovascular diseases and older people should avoid the heat as much as possible, take it easy physically and move strenuous activities such as sports to cooler rooms (e.g. ergometer at home) or phases such as the morning or evening. Extreme heat puts the body under so much stress that blood pressure can increase.
“This is also why patients with high blood pressure suffer particularly during hot periods.”
Prof. Dr. Thomas Voigtlander
But the opposite can also be the case because blood pressure can drop sharply due to the heat and the dilating vessels, leading to fainting, dizziness or arrhythmias. Sometimes blood pressure drops so low that the dose of blood pressure medication needs to be adjusted. You should therefore keep a close eye on your blood pressure by measuring it regularly so that you can react quickly if necessary. However, dosage changes should only be made in consultation with the treating doctor.
Heart patients should pay particular attention to these medications in hot weather
Heart patients may need to change the dosage of their heart medication, especially during long periods of extreme heat. This concerns e.g. For example, in addition to antihypertensive medications ( beta blockers , ACE inhibitors, sartans and calcium antagonists), there are also diuretics (water medications) for heart failure patients so that they do not lose more fluid than they already do through increased sweating.
“Cardiovascular patients should discuss with their doctor which medications should be reduced and for how long in the heat.”
Prof. Dr. Thomas Voigtlander
Patients with a tendency to thrombosis should also note that heat (and cold) can increase the blood's ability to clot and promote inflammatory processes in the vessels. “At high temperatures, the viscosity of the blood increases due to the loss of fluid through sweating,” says Voigtländer, also with regard to heart patients who take anticoagulants. Here too, those affected with a tendency to thrombosis due to the heat problem should speak to their family doctor or cardiologist.
Drinking enough is important for electrolyte balance - be careful with diuretics!
The body also gives off heat through sweat, but loses fluid and electrolytes (blood salts: sodium, potassium, magnesium): one to two liters of fluid per day in very hot weather. Electrolytes such as potassium and magnesium ( info HERE ) are important for heart function and blood pressure regulation. Drinking is therefore important to compensate for this loss of fluid and salt.
When healthy people are thirsty, they automatically drink as much as they need to compensate. But in older people or people with heart disease, the feeling of thirst may not be fully intact, so they do not drink enough and the fluid loss is not compensated for. Older people are therefore encouraged to drink enough on hot days, i.e. an additional one to two liters per day.
But “enough” also means: not too much! Excessive fluid intake can lead to a deterioration in cardiac performance, especially in patients with heart failure. “Heart patients should therefore coordinate the amount they drink, as well as the medication they take, with their doctor. For example, daily weighing helps those with heart failure to determine the right amount to drink.” In hot weather, you should prefer mineral water, herbal tea or diluted fruit juice. Alcohol is not recommended. Drinks should not be cooled too much, otherwise heat production in the body will be stimulated.
Tip: Weigh yourself daily to check the amount you drink
Patients with heart failure in particular should weigh themselves in the morning before breakfast and after going to the toilet for the first time. In general, regular weighing in the morning is sufficient to check fluid balance. When it's very hot, you can roughly estimate your fluid balance over the day by weighing yourself in the evening: If your body weight has increased by more than 500 grams, the daily amount you're drinking is too high. If you have heart failure and have lost weight despite drinking fluids, you should only reduce the dose of diuretics in consultation with your doctor.
Further information:
Important information for cardiovascular patients on the subject of heat
From the consultation
information on potassium and magnesium deficiency
Source: German Health Portal
This might also be of interest: Protecting older people from heat
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